Not lengthy after California surgeon Andrew S. Hsu landed a job with a beauty surgical procedure chain in Georgia, a number of of his sufferers suffered disfiguring accidents, and even his new employer had doubts about his competence, courtroom information allege.
Hsu, a board-certified normal surgeon, was one in every of six out-of-state docs who joined the Atlanta Targets Aesthetics & Plastic Surgical procedure heart throughout the pandemic. The surgeons obtained momentary licenses to observe in Georgia, which state officials granted in response to the sudden want for extra medical personnel to handle the covid-19 outbreak — although the middle specialised in elective beauty surgical procedures, akin to Brazilian butt lifts, or BBLs, and liposuction, paid for in money or on credit score.
The Atlanta heart announced its opening in March 2021 as an growth of New York-based Targets Aesthetics & Plastic Surgical procedure, which markets “precision physique contouring” for a few dozen surgical procedure clinics in eight states, promising sufferers a “dream body in just one visit.”
However the Atlanta heart’s early days had been marred by allegations of substandard affected person care. Court docket information present that at the very least 20 ladies filed medical malpractice lawsuits in opposition to the ability, or its proprietor and surgeons. Hsu was named as a defendant in seven fits filed in opposition to the Atlanta heart, greater than every other doctor there. An eighth affected person sued Hsu alleging negligence in an operation he carried out at a Targets workplace in New York.
Hsu didn’t reply to requests for remark. Targets declined to remark. Each have denied any negligence.
Beauty surgical procedure chains throughout the nation are attracting sufferers by promising “minimally invasive” operations to reshape their our bodies or eliminate cussed fats — even serving to prepare exterior financing for individuals who can’t pay up entrance. A whole lot of hundreds of sufferers are present process such procedures annually, and plastic surgeons could make greater than $500,000 annually in one of the highest-paid specialties in American medication.
An investigation by KFF Well being Information discovered that lawsuits filed by injured sufferers have trailed the business’s development, in some circumstances alleging that surgeons lacked ample coaching, had histories of malpractice lawsuits, or had confronted disciplinary motion by state medical licensing boards — but crossed into one other state and stored working towards.
Within the Atlanta lawsuits, Targets has denied any negligence and received dismissal of a number of of them as a result of sufferers had signed papers agreeing to exterior arbitration — which requires them to resolve disputes privately and outdoors the courtroom system.
But Targets argued in a separate contract dispute that a number of of its Atlanta surgeons, together with Hsu, had been certainly susceptible to issues — both as a result of they lacked ample coaching or had troubled pasts, together with investigations by state medical licensing boards into misconduct, courtroom information present. One among Hsu’s Atlanta sufferers mentioned in a separate lawsuit that she suffered in ache for over a yr as a result of a chunk of a scalpel was left inside her physique after a BBL and liposuction.
In a June 2023 courtroom submitting in that contract dispute, Targets blamed the issues on a medical staffing agency — Barton Associates, a private equity-owned agency in Massachusetts — it mentioned didn’t do ample background checks on the docs it equipped. Barton denied the allegations and mentioned it met all phrases of the contract.
No public database exists to assist sufferers be taught the complete observe histories of physicians, together with beauty surgeons. And sufferers are largely left on their very own to decipher which certificates hanging on a surgeon’s wall, or ballyhooed in online advertising, signify acceptable coaching and which don’t. Disputes amongst medical specialty teams over whose members are the best qualified to carry out beauty operations — and ship the perfect outcomes — add to the confusion.
No authorities company tracks accidents or different complication charges at clinics providing beauty surgical procedure or every other kind of operations. And in lots of jurisdictions, together with Georgia, getting access to courtroom information — a attainable pink flag for recognizing issues — is laborious and dear.
Charleetra Hornes, 52, who lives within the Atlanta suburbs and is suing the Targets heart for medical malpractice, mentioned she knew nothing of its alleged early troubles and selected the corporate as a result of its promoting promised “minimal downtime” for restoration and that she would stay awake throughout the operation.
She mentioned she paid $6,650 for a “double BBL,” wherein fats is suctioned from the abdomen, purified, and injected into the buttocks and hips to create what Targets calls a “natural-looking enhancement.”
Targets went forward along with her surgical procedure on July 2, 2022, although she had examined optimistic for covid that day, in keeping with the go well with. Hornes alleged that two days earlier than the surgical procedure Targets assigned her to surgeon Thomas Shannon, who has labored for Targets in Georgia and Texas.
Although employees gave her drugs to handle the discomfort, Hornes mentioned, she suffered “excruciating ache” throughout the process, in keeping with the go well with.
That evening, she spiked a fever that despatched her to the emergency room. She spent two weeks within the hospital recovering from accidents, together with a “extreme burn on her facet,” in keeping with the go well with.
“I’ve been disfigured and burned up, and it’s not truthful,” she mentioned in an interview.
In June 2024, Hornes sued Shannon, the Targets heart, and Barton Associates, alleging malpractice. On Sept. 2, a Georgia choose dismissed Shannon from the case, ruling that Hornes didn’t serve him with the criticism in Texas earlier than the statute of limitations ran out. He didn’t reply to requests for remark.
In a separate order issued on the identical day, the choose additionally dismissed the opposite defendants, citing the statute of limitations situation and that Hornes had beforehand signed an arbitration settlement. Some beauty surgical procedure chains and different medical practices ask sufferers to signal such agreements.
Hornes needs she had realized extra in regards to the Atlanta surgical procedure heart, as a substitute of accepting what she calls its “flashy” come-ons. “I want I’d have taken it extra critically,” she mentioned in an interview, “as a result of it was life-altering.”
Helpful Instruments
KFF Well being Information recognized greater than 200 lawsuits filed in opposition to multistate beauty surgical procedure firms, principally over the previous seven years, together with circumstances involving a dozen deaths, utilizing databases of courtroom information.
Lawsuits by themselves don’t show wrongdoing. Many circumstances are settled below confidential phrases that preserve essential particulars below wraps. But medical authorities and most doctor licensing boards regard malpractice circumstances and settlements as a helpful tool for detecting attainable patterns of substandard well being care which will hurt sufferers.
Court docket information present that surgeons who had been sued quite a few occasions for malpractice — and in some circumstances disciplined by state medical boards for misconduct — have managed to get employed by beauty surgical procedure chains.
Targets, owned by doctor Sergey Voskin, has contracted with eight surgeons with three or extra malpractice circumstances filed in opposition to them, together with within the Atlanta space, courtroom information allege. Gerald Hickson, founding director of the Vanderbilt Middle for Affected person and Skilled Advocacy and an skilled on medical malpractice points, known as that variety of fits a “warning” of attainable issues, regardless of their end result.
Earlier this yr, a Pennsylvania girl recognized in courtroom filings as “P.C.” sued Targets, Voskin, and surgeon Peter Driscoll, alleging Driscoll got here on board regardless of an “in depth historical past of malpractice allegations, licensing suspensions and self-discipline” in Texas and California, in keeping with medical board information cited within the go well with. Firms hiring docs have prepared entry to the nonpublic National Practitioner Data Bank, which particulars disciplinary issues in a physician’s previous. Nevertheless it’s not clear from courtroom information whether or not anyone made these customary background checks. Targets didn’t reply to a request for remark.
The go well with additionally accuses Targets of client fraud for touting its surgeons as “double if not triple board licensed plastic surgeons.” In accordance with the criticism, Driscoll was board-certified by the American Board of Otolaryngology, a specialty that focuses on therapy and surgical procedure of head and neck areas. Driscoll is no longer certified within the specialty, in keeping with the American Board of Medical Specialties web site.
The girl alleges that Driscoll sexually harassed her and made “undesirable and unwelcome sexual contact” throughout a BBL process in June 2022 at a Targets workplace in New Jersey.
In accordance with the go well with, employees members overheard Driscoll watching pornography in an workplace rest room a number of occasions, however Targets didn’t terminate him on the time. New Jersey’s State Board of Medical Examiners suspended Driscoll’s license in February 2023 associated to the incident, and the lady’s lawsuit is pending in federal courtroom in New Jersey. Targets and Voskin have denied the allegations within the go well with and filed a movement to dismiss or compel arbitration of the case. Driscoll, who has not filed a response with the courtroom, couldn’t be reached for remark.
Efficiency Points Not ‘Disqualifying’
Different beauty surgical procedure chains have confronted a number of malpractice actions concentrating on surgeons or different well being care suppliers who employees their clinics, courtroom information present.
The surgeon roster at Mia Aesthetics, a Miami-based chain that operates 13 beauty surgical procedure workplaces nationwide, lists 4 docs with three or extra malpractice actions since 2020, courtroom information present.
Almost a dozen injured sufferers have filed lawsuits criticizing the credentials of docs and nurse practitioners affiliated with Belle Medical, together with the household of a 70-year-old Utah girl with 5 kids who died within the automotive two days after liposuction as her husband rushed her from residence to a hospital, in keeping with courtroom information.
Her husband alleges he known as Belle Medical’s workplace the day after the process to say his spouse was having problem respiration and coronary heart palpitations and couldn’t stroll greater than a brief distance, which the lawsuit argued had been “textbook signs of pulmonary embolism, or blood clot within the lung.” In accordance with the go well with, no person at Belle Medical suggested the household to hunt instant medical care. An post-mortem discovered she died from “bilateral pulmonary emboli,” in keeping with the go well with.
Backed by Peterson Companions, a Utah personal fairness and funding agency, Belle Medical operates in Utah, Idaho, and Oklahoma, providing liposuction and different beauty surgical procedure. Neither Belle Medical nor Peterson Companions responded to requests for remark. In courtroom filings, Belle Medical has argued that its medical suppliers are impartial contractors who’re solely chargeable for any procedures they carry out.
Personal equity-backed Sono Bello, the most important of the beauty surgical procedure chains with greater than 100 areas nationwide, has defended greater than a dozen lawsuits alleging the corporate contracted with inadequately educated docs or practitioners beforehand disciplined by medical licensing boards. In Could 2023, Ohio’s medical board revoked the license of a Sono Bello contract surgeon after three of her sufferers died, two of them following procedures at a Sono Bello workplace within the Cleveland space, in keeping with medical board information.
Robert Centeno, Sono Bello’s medical director for the East area, informed KFF Well being Information that many surgeons have previous efficiency points, which he known as “not, in truth, disqualifying.”
“The overwhelming majority of our colleagues are extraordinarily skilled and dedicated to their career,” he mentioned in an interview. “And whereas there could also be a momentary lapse or situation with their observe, most of our surgeons take these sanctions, take that counseling, that recommendation, and enhance their practices and go on to be very, very productive members of the medical neighborhood.”
Requested about malpractice lawsuits filed in opposition to the corporate, Centeno mentioned that Sono Bello has “carried out over 300,000 procedures so far,” which he described as “extra procedures for extra sufferers accomplished safely than anybody else within the business. It will be pure and comprehensible to know that sooner or later throughout that course of, {that a} affected person has truly sued us,” Centeno mentioned.
‘Unable To Carry out’
In early 2020, because the pandemic slowed enterprise in New York Metropolis, Targets sought to develop to Atlanta — a scorching marketplace for its BBLs. In a PR Newswire release, Targets promised sufferers “superb contours” and boasted of getting “a number of the most skilled, and aesthetically ahead surgeons within the business.” BBLs and liposuction make up 95% of its enterprise, marketed to principally Black and Hispanic ladies, Targets proprietor Voskin testified in a deposition filed this yr within the Driscoll case. Many Atlanta sufferers suing the corporate paid roughly $6,000 to $8,000 for his or her surgical procedures, courtroom information present.
Targets initially staffed the Atlanta heart by way of Barton Associates. Many hospitals and medical workplaces depend on such corporations to search out momentary docs and different employees. Underneath the deal, Barton charged Targets $1,400 for every process and paid about $600 of that to the surgeon, in keeping with Targets’ courtroom filings.
In 2023, Barton sued Targets in a Massachusetts courtroom, alleging it was owed $487,000 in charges. Targets admitted that it “briefly ceased cost” to Barton. Nevertheless it fired again with a counterclaim accusing Barton of failing to test the {qualifications} and backgrounds of surgeons as required by the settlement.
Targets named 5 surgeons Barton despatched to the middle, together with Hsu, and pointed to the spate of malpractice circumstances in Atlanta to bolster its argument.
Targets mentioned it “grew to become instantly obvious” that one other surgeon was “basically unable to carry out his duties.” The surgeon was “abrasive, vulgar and couldn’t conduct himself in accordance with affordable skilled requirements that had been anticipated in a medical office,” in keeping with Targets’ counterclaim.
A second surgeon Barton introduced as “extremely expert” turned out to have “an in depth historical past of complaints about his skilled conduct” in two different states, in keeping with the counterclaim.
Barton and Targets settled the case and counterclaim in April 2024 below confidential phrases. Barton didn’t reply to requests for remark. Barton denied Targets’ allegations in earlier courtroom filings and mentioned that it “complied totally” with the phrases of its contract with the surgical procedure firm.
In its counterclaim, Targets argued that shortly after Hsu joined the employees in 2021, it realized he had “a number of points” in California and “was about to lose his medical license consequently,” in keeping with a courtroom submitting.
Targets offered “vital authorized and different help” to maintain that from taking place and Hsu “required substantial coaching in an effort to do acceptable work on sufferers,” the corporate argued in courtroom filings.
Seven ladies filed malpractice fits in 2023 alleging they sustained accidents from BBLs and liposuction Hsu carried out on the Atlanta workplace between mid-February 2021 and the top of June 2021, courtroom information present. Barton, the staffing agency, is also a defendant in these circumstances and has denied wrongdoing. Hsu has denied wrongdoing within the circumstances and sought to implement arbitration agreements.
Hsu’s emergency Georgia medical license, authorised in January 2021, expired in April 2022, state information present. Hsu is licensed in New York and California, the place he has additionally labored for Targets.
Two fits accuse Hsu of leaving a chunk of steel contained in the our bodies of girls, a calamity affected person security specialists consider should never occur.
In a single Atlanta case, a affected person who alleged she had skilled fixed ache since her surgical procedure at Targets in 2021 mentioned she found why greater than a yr later when a chest X-ray ordered after a automotive crash confirmed a chunk of scalpel blade in her higher stomach, in keeping with her courtroom filings. The motion in opposition to Hsu and Barton Associates was settled early this yr, courtroom information present.
Within the second case, a New Jersey girl who had a BBL at Targets’ Harlem workplace in New York Metropolis in February 2022 alleged she overheard Hsu say within the working room that he had “left one thing inside her,” which turned out to be a steel liposuction cannula tip that had damaged off in her abdomen. A choose dismissed her lawsuit attributable to an arbitration clause. She filed a discover of enchantment, however the case was settled in August.
The California medical board’s investigation of Hsu resulted in October 2023 with a settlement and disciplinary order. The state accused him of “repeated negligent acts” in treating six sufferers relationship to 2016, together with three individuals who died. None concerned beauty surgical procedure like his work at Targets.
The board revoked his license however stayed the motion and imposed a four-year probation, tacking on a $24,000 penalty to cowl prices of the investigation. The order additionally required Hsu to discover a practitioner to assist oversee his observe and prohibits him from serving on any on-call panel for normal surgical procedure. In settling the case, Hsu didn’t admit any wrongdoing.
Targets has featured Hsu in a TikTok video, and boasts on its website that he’s a “extremely expert surgical specialist,” who offers “top-notch surgical care.”
Fellowship Coaching
How a lot coaching beauty surgical procedure chains demand of surgeons varies, judging by doctor service contracts obtained by KFF Well being Information by way of courtroom filings. Some contracts merely require that the physician maintain a legitimate state medical license, whereas others specify that a physician “represents” that they are qualified to carry out beauty surgical procedure and haven’t been disciplined by licensing boards or been hit with main malpractice awards.
Sono Bello takes a special route. The corporate sponsors a six- to eight-week coaching course for surgeons, which it calls a “fellowship,” and posts details online.
Sono Bello accepts candidates from greater than half a dozen surgical specialties and focuses its coaching on liposuction and a sort of tummy tuck procedure called AbEX.
Court docket information present that Sono Bello has defended at the very least a dozen lawsuits from sufferers who argued some surgeons lacked ample coaching or had different issues, or alleged they had been misled by some promoting that described surgeons who accomplished the fellowship as “board licensed plastic surgeons.”
Sono Bello’s credentialing course of got here below assault in a 2023 malpractice lawsuit filed by Shirley Webb, a 79-year-old Nevada girl who spent months in hospitals and rehabilitation care recovering from sepsis after a tummy tuck and liposuction carried out by surgeon Charles Kim in Las Vegas in December 2022.
Kim, a colorectal surgeon, took the Sono Bello fellowship from July 2022 to October 2022, courtroom information present. In a deposition, Kim, who’s board-certified normally surgical procedure, acknowledged that Sono Bello knew he had been disciplined by Nevada’s state medical licensing board for alleged malpractice wherein a affected person he operated on died. Kim paid a $4,000 tremendous and obtained a letter of reprimand in settling the medical board case with out admitting wrongdoing.
Kim additionally testified within the medical malpractice case that Sono Bello was conscious he had beforehand settled 4 medical malpractice circumstances, courtroom information present. Christopher Chung, Sono Bello’s chief medical officer, mentioned the corporate verified that Kim’s state medical license and different credentials “had been updated and in good standing” earlier than it employed him. “We reviewed his surgical log, which detailed the voluminous and complicated surgical procedures he had carried out on the hospital the place he was then employed, and obtained optimistic references from his employer and different surgeons,” Chung mentioned in an emailed assertion.
A medical skilled employed by Webb’s authorized group opined that Sono Bello’s use of the time period “fellowship” is misleading as a result of this system will not be accredited, or acknowledged by any subspecialty certifying board, skilled society, or hospital. A medical fellowship is usually a coaching program that lasts at the very least a yr. “We strongly disagree with the suggestion that our web site is deceptive. We precisely state that our physicians are board-certified surgeons — as a result of they’re,” Sono Bello spokesperson Mark Firmani mentioned in response.
In her lawsuit, Webb testified that Sono Bello’s ads on tv and on-line led her to consider the corporate employed solely board-certified plastic surgeons.
Had she been informed of Kim’s background prematurely, “I wouldn’t have had the surgical procedure finished,” Webb testified in a 2024 deposition.
The events settled the go well with early this yr below confidential phrases.
Have you ever had liposuction, a “Mommy Makeover,” a tummy tuck, a Brazilian butt carry, or one other kind of beauty surgical procedure? We’d like to listen to about your expertise. Click here to contact our reporting group.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Study extra about KFF.
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